Dr. Ashaq Hussain Parrey
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My HbA1c is 8 and fasting glucose is 140. My urine microalbumin to creatinine ratio is 116. What do these values mean?
Hello,
Welcome to icliniq.com.
You seem to have diabetes because both blood sugar fasting and HbA1c (glycated hemoglobin) are in the diabetic ranges.
You also have microalbuminuria.
You have not mentioned what medications you taking because both blood sugar and microalbuminuria can be controlled with medicines.
Kindly mention what medications you are taking to make any change or modifications.
For more information consult an internal medicine physician online.
Patient's Query
Thank you doctor,
I m still not taking any medicines. But, I am going to start from today. My question is does microalbumin to creatinine ratio high. Does it mean the kidney damage is beyond control? Can it be reversed with diet and exercise? Can diabetes be reversed as my HbA1c last month was 6.5?
Hello,
Welcome back to icliniq.com.
Microalbuminuria is in the initial stage of diabetic disease and can be controlled and even reversed to normal with medicines called ACE (angiotensin-converting-enzyme) inhibitors or ARB (angiotensin II receptor blockers).
Well, diabetes can be controlled with diet, exercise, and medicine.
Sometimes exercise and diet alone can control diabetes but most of the time, medicine is necessary and unlikely that it will reverse.
You may have to live with diabetes for the rest of life.
I think you should start Metformin 850 mg once with dinner from today only. Consult your specialist doctor, discuss with him or her and with their consent take the medicines.
For more information consult an internal medicine physician online.
Patient's Query
Thank you doctor,
My father and grandfather both have diabetes and they are healthy at 85. But this microalbumin to creatinine ratio at 116 level in the blood is something that I am not able to understand. I only understand that the kidneys are not working fine. Is it true? I hope my kidneys are fine. My Kidney function tests are normal except high uric acid. I hope there is nothing serious? Can this also be reversed with diet and medicine.
Hello,
Welcome back to icliniq.com.
Yes, there is nothing serious at this point in time.
As I said microalbuminuria between 30 to 300 micrograms is the first step in diabetic kidney disease.
It is reversible with ACE (angiotensin-converting-enzyme inhibitor) inhibitors and ARBs (angiotensin II receptor blockers).
So, you need not worry.
For more information consult an internal medicine physician online.
Patient's Query
Thank you doctor,
I checked my reports from last year. My HbA1c was 6.4 and even 20 days back it was 6.9. I do not know how it increased to 8 in just 20 days. Can this be reversed by any chance? Also, my sugar is 140 in the morning and in the evening after six hours of not eating it becomes 105. I fail to understand the reason.
Hello,
Welcome back to icliniq.com.
It seems in the last 20 days that you have had high levels of blood glucose which has increased the HbA1c (glycated hemoglobin).
Even if we presume that it has shown more than expected but it is still diabetes.
Unless you start treatment you will harm yourself and will result in a long-term problem.
So, start medications as early as possible.
For more information consult an internal medicine physician online.
Patient's Query
Thank you doctor,
Also, what medicine can be taken for reducing the microalbumin to creatinine ratio? The doctor gave me Telma 40 mg. Is it for reducing the microalbumin to creatinine ratio?
Hello,
Welcome back to icliniq.com.
Yes, Telma (Telmisartan) is an ARB (angiotensin II receptor blocker) and is FDA (Food and Drug Administration) approved for microalbuminuria.
Consult your specialist doctor, discuss with him or her and with their consent take the medicines.
For more information consult an internal medicine physician online.
Patient's Query
Thank you doctor,
Also, I would like you to inform that my blood sugar now after walking for 45 minutes is 90.
Hello,
Welcome back to icliniq.com.
Well, that is good. But you need not do repeated blood sugar.
It is obvious that if you take medications and exercise, the blood sugar will stay low
This is what the treatment of diabetes is.
For more information consult an internal medicine physician online.
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